People Want to Grow Old at Home

State expanding home and community services

Carl Meyers, of Westerville, uses a Hoyer hoist to move his wife to a recliner. A Medicaid-provided caretaker comes daily to help Carl care for Edith, who had a stroke five years ago. — Andrew Spear/Aurora Select

Carl Meyers was concerned about his ability to care for his wife, Edith, when she came home from the hospital after surgery and a stroke five years ago.

"I thought, 'Hoyer hoist? What's a Hoyer hoist?' " the 85-year-old Westerville resident recalled, referring to a type of hoist that helps caregivers safely lift a person from a bed to a chair. "I've never taken care of anybody before."

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His concerns eased once Edith, 84, qualified for a home-based Medicaid program that covers a number of services, including daily visits by health aides. They were glad to have the opportunity to keep Edith out of a nursing home. They're not alone in that desire.

A 2011 survey of AARP Ohio members found nine out of 10 think it's extremely or very important to have long-term care services that help family members stay in their own homes as long as possible. But only about half of those interviewed felt well informed about such services.

Bonnie Kantor-Burman, director of Ohio's Department of Aging, said she hopes to make these types of services easier to understand and more widely available.

"When we know what people want, and it's appropriate, and it happens to cost less, it's a pretty easy decision to make," she said.

By next year, the agency wants half of its Medicaid clients enrolled in home- and community-based programs, which typically cost about a third to half as much as nursing homes. Currently about 42 percent are enrolled in such programs, with the balance receiving nursing home care.

A number of initiatives have been proposed to pave the way. Starting this summer, Gov. John Kasich, R, wants Medicaid's long-term care funding placed in one unified budget.

Ohio now spends about 24 percent of its long-term care budget on home- and community-based services for older adults and people with physical disabilities. By comparison, states such as Washington, Minnesota and Oregon spend up to 62 percent.

Ohio is moving in the right direction but needs to accelerate its efforts, said Robert Applebaum, director of the Ohio Long-Term Care Research Project at Miami University's Scripps Gerontology Center in Oxford.

The state's aging and disabled populations are projected to skyrocket. Between now and 2040, Ohio's 65-and-older population is expected to double to more than 3 million. The older population with severe disabilities is expected to double to about 300,000.